Patient-reported outcomes favor below-knee over above-knee amputation in patients with nontraumatic lower extremity wounds.

BACKGROUND

Below-knee amputation and above-knee amputation are often last-resort treatment options for chronic lower extremity wounds.

OBJECTIVE

To compare, for the first time, patient-reported outcome measures in patients who underwent below-knee amputation or above-knee amputation for nontraumatic chronic lower extremity wounds.

METHODS

Patient-reported outcome measures, including the 20-item Self-Reporting Questionnaire, the Patient-Reported Outcomes Measurement Information System Pain Intensity 3-item scale, the Connor-Davidson Resilience Scale, and the Lower Extremity Functional Scale, were collected for patients who underwent above-knee amputation or below-knee amputation and who presented to a tertiary wound center between June 2022 and October 2024. Mental well-being, pain intensity, resilience, and function were measured at 1 month, 3 months, 6 months, 1 year, 2 years, and 5 years postoperative.

RESULTS

Of 96 patients, 22 underwent above-knee amputation and 74 underwent below-knee amputation. Significant differences were observed between patients who underwent above-knee amputation versus below-knee amputation in mean overall function, psychological distress, and pain intensity.

CONCLUSION

Patients who underwent above-knee amputation had higher pain intensity, more psychological distress, and lower function compared with patients who underwent below-knee amputation.